Alternatives to MDaudit
Compare MDaudit alternatives for your business or organization using the curated list below. SourceForge ranks the best alternatives to MDaudit in 2025. Compare features, ratings, user reviews, pricing, and more from MDaudit competitors and alternatives in order to make an informed decision for your business.
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1
XpertCoding
XpertDox
XpertCoding is an AI-powered medical coding software by XpertDox that uses advanced AI, natural language processing (NLP), and machine learning to code medical claims automatically within 24 hours. It automates the coding process, enabling faster and more accurate claims submissions to maximize financial gains for healthcare organizations. Features include minimal human supervision, easy EHR connectivity, flexible cost structure, a significant reduction in denials and coding costs, a HIPAA-compliant business intelligence platform, risk-free implementation with no initial fee and a free first month, and higher coding accuracy. XpertCoding's autonomous coding solution helps healthcare providers and organizations get paid faster, accelerating the revenue cycle and allowing them to focus on patient care. Opt for XpertCoding for a reliable and accurate medical coding software solution for your practice. -
2
Healthicity Audit Manager
Healthicity
For medical auditing, Audit Manager streamlines the way you manage audits by merging audit workflow, management, education, and reporting into one easy-to-use, web-based solution. Audit Manager brings simplicity by helping you: Identify Revenue Evaluate financial impact. Minimize denials and identify up to 10%, per provider, in missed revenue with extensive reporting and analytics tools. Increase Efficiency Improve your auditing efficiency by up to 40%. Reduce the amount of time you spend completing audits with our user-friendly interface. Improve Accuracy Customize your audit templates. Include your own standards, MAC carrier guidelines, and claim scrubber tech for ideal results. Audit Manager features: Built-in Tableau integration for in-depth analytics and reporting. Flexible Audit Management: View the status, and each associated status, of every audit, by any auditor. E/M Calculator Automatically calculate E/M codes with a built-in calculator.Starting Price: $670/mo for 3 users -
3
Axora
Axora.AI
Axora AI is an intelligent, end-to-end claims engine that blends AI-powered automation with billing expertise - managing everything from eligibility to payment posting. But it’s more than automation. Axora AI prevents denials before they happen, adapts to payer rule changes, and prioritizes what matters - so you recover more revenue with less effort. 1. Manages your full claims cycle from start to finish 2. Flags denial risks before submission 3. Prioritizes actions that improve cash flow 4. Seamlessly fits into your EHR, payer, and finance systems 5. No migrations. No disruption. Just faster, cleaner paymentsStarting Price: $30/month -
4
CombineHealth AI
CombineHealth AI
CombineHealth AI is the creator of Amy, Marc, Emily, and Diana — an advanced AI workforce designed to power end-to-end Revenue Cycle and Practice Management services for healthcare groups nationwide. These solutions are built on a proprietary foundational model that delivers 99.2% accuracy and ensures 100% compliance with coding and billing guidelines. The AI workforce helps reduce coding errors, enhance coder productivity, and address physician documentation challenges. Organizations using these solutions have seen a 35% increase in clean claim submissions and a significant reduction in denial rates. The AI employees work seamlessly alongside human teams, performing key functions such as medical coding, billing, data entry, A/R follow-up, and denial management — while providing detailed, auditable reasoning for every action taken.Starting Price: $1000/month -
5
Aria RCM
eMDs
Every practice’s revenue cycle is the same. It starts when a patient sets an appointment and it ends when the practice receives payment. It sounds simple enough, but the reality is there are lots of opportunities along the way where simple mistakes can cost your practice money. At eMDs, we don’t simply process claims. That’s the easy part. Instead, we help our customers navigate the entire revenue lifecycle with our expertise understanding payer billing rules, audits, recoupments, appeals and denials, and much more. Why is this important? Your revenue cycle is like a production line. Each step has to be perfectly executed so the next one can be. One little hiccup and the production line (your revenue) comes to a screeching halt. By leveraging best practices developed over our 20+ years in business, our team of industry experts, and our proprietary technology, Aria RCM ensure your billing lifecycle is set up for maximum revenue collection. -
6
I-Med Claims
I-Med Claims
I-Med Claims provides top-tier medical billing and revenue cycle management (RCM) solutions, trusted by healthcare practices across the U.S. We handle all aspects of RCM, from eligibility verification to denial management, helping practices streamline operations and maximize reimbursements. With billing plans starting at just 2.95% of monthly collections, we offer affordable solutions that enhance financial workflows, maintain compliance, and improve cash flow. By outsourcing billing to us, practices can focus on patient care while benefiting from reduced claim denials and faster payments. -
7
Quanum RCM
Quest Diagnostics
Quanum Revenue Cycle Management (RCM) delivers a holistic solution for managing the financial component of a medical practice with a focus on increasing revenue. Created by Quest Diagnostics, a leading provider of pre-employment drugs-of-abuse screening for employers and risk assessment services for the life insurance industry, Quanum RCM offers a complete medical billing solution, from billing claims to denial management and other billing related activities and support. -
8
OptiPayRCM
OptiPayRCM
OptiPayRCM’s platform delivers seamless, “last-mile” revenue cycle management automation by integrating with EHRs, clearing houses, payer portals, and other systems via flexible adapters so your billing workflows can be processed end-to-end. Its unified core engine handles eligibility checks, claim submissions, payment postings, denial management, and full accounts receivable workflows using AI and robotic process automation to reduce manual effort and accelerate cash flow. Real-time dashboards and reports provide visibility into key metrics and enable predictive insights, while customizable automation supports exceptions and unique workflows. It reduces first-pass denials by up to 63%, speeds claim status checks up to 50 times faster than human processing, and reduces payment cycle time by up to 35%. It is compatible with more than 200 healthcare systems and supports direct integrations via EHRs, FHIR, EDI, and HL7. -
9
Experian Health
Experian Health
Patient access is the starting point for your entire revenue cycle process. Ensuring correct patient information on the front end reduces the errors that cause rework in the back office. 10 to 20 percent of a health system's revenue is forced to remediate denied medical claims and 30 to 50 percent of those occur during patient access. By adopting an automated, data-driven workflow—not only are you reducing the errors that lead to claim denials, you’re also improving access to care for your patients through capabilities like online scheduling options that are available 24/7. Access is further improved by reducing the friction around patient billing by leveraging real-time eligibility verification to deliver accurate patient estimates at registration. Increase staff efficiencies by improving registration accuracy. Correct discrepancies and errors in real time to avoid costly denials and rework. -
10
Droidal
Droidal LLC
Droidal is an AI-powered revenue cycle management platform that helps healthcare organizations reduce costs, increase revenue, and improve patient experiences. By leveraging Generative AI and large language models (LLMs), Droidal automates complex billing, claims, and payment workflows with precision and speed. The platform processes over 2 million claims monthly across 1,800+ locations while maintaining coverage for 3,500+ payers. Its AI agents streamline operations for hospitals, clinics, and care providers — cutting denials, accelerating payments, and boosting cash flow. Designed for seamless integration, Droidal enhances productivity without replacing existing systems or workflows. With enterprise-grade compliance and a subscription-based model, Droidal delivers measurable ROI while freeing up staff to focus on patient care. -
11
Anomaly
Anomaly
Anomaly is an AI-powered payer management platform built for healthcare revenue teams to “know your payers as well as they know you.” It surfaces hidden payer behaviors by decoding complex rules and detecting payment patterns across hundreds of millions of healthcare encounters. The core engine, Smart Response, continuously analyzes payer logic, adapts to shifting policies, and embeds learnings directly into existing revenue cycle workflows to provide real-time denial prediction, assisted claims correction, and alerts to revenue risks. By integrating payer-specific insights into existing systems, users can anticipate revenue loss, negotiate payer contracts from a stronger position, and proactively correct or reverse denials before they impact cash flow. The system helps level the playing field between providers and payers by turning opaque billing logic into actionable intelligence and embedding it into day-to-day financial operations. -
12
iMedX
iMedX
iMedX, Inc. provides clinical documentation and revenue-cycle solutions designed to help healthcare providers focus on patient care rather than administrative burdens. The platform supports AI medical coding, standard medical coding, clinical documentation, abstraction of core measures, and revenue-cycle-management workflows. Their AI medical coding offering, part of the ‘RCM Companion Suite’, uses advanced machine-learning to improve accuracy, reduce denials, and accelerate payments by automating case-routing, pre‐populating codes, guiding coders in real time, and surfacing documentation gaps before claims leave the organization. Users gain features such as intelligent case routing to the right coder, autonomous resolution of routine cases, in-moment assistance through an AI assistant, and embedded audit tools that identify missed reimbursement, documentation errors, and compliance risks. -
13
SSI Claims Director
SSI Group
Elevate your claims management process and decrease denials through unmatched edits and an industry-leading clean claim rate. Health systems require access to technology that facilitates accurate claim submission and rapid reimbursement. Claims Director, SSI’s claims management solution, streamlines billing practices and provides visibility by guiding users through the electronic claim submission and reconciliation process from beginning to end. As payers change or modify reimbursement criteria for services, the system actively monitors and incorporates these changes and requirements. And with a comprehensive mix of edits at the industry, payer and provider levels, the solution aids organizations in making the most of reimbursement efforts. -
14
LigoLab LIS & RCM
LigoLab
As a comprehensive enterprise-grade solution, the LigoLab LIS & RCM Laboratory Operating Platform™ includes modules for AP, CP, MDx, RCM, and Direct-to-Consumer, all on one integrated platform that supports the entire lifecycle of all cases, enabling laboratories to differentiate themselves in the marketplace, scale their operations, and become more profitable. The RCM module is deeply integrated with the LIS and automates ICD and CPT coding. Billing processes start at order inception with verification, eligibility, and scrubbing components that increase clean claim submissions and revenue, and decrease claim denials and compliance risk. TestDirectly is a patient engagement portal that enables labs and collection facilities to scale collection, testing, and reporting workflows that produce fast and accurate results, minus the friction and the errors that come with paper forms and manual labor. -
15
Encipher Health
Encipher Health
Encipher Health is a comprehensive AI-powered healthcare technology platform that automates medical coding, risk adjustment, and revenue-cycle processes across specialties. Using Neuro-Symbolic AI, OCR, ML, and knowledge-graph logic, it converts unstructured clinical documentation into accurate, audit-ready codes (CPT, ICD-10, HCC, HCPCS) while enforcing payer, CMS and compliance rules. Its products — including GI coding automation, radiology coding (Conrad AI), anesthesia coding (Sedate AI), HCC/risk adjustment (Cogent AI / RiskGen‑Core / RAF Totalizer), E/M coding, home-health coding, ICD-10-AM support, AR follow-up and denial resolution — streamline workflows, reduce manual effort, minimize denial risk, and accelerate reimbursements. Real-time and retrospective workflows, seamless EHR integration, MEAT-criteria validation, modifier logic, and compliance guardrails ensure high accuracy, regulatory alignment and audit readiness. -
16
RevCycle Engine
Aptarro
RevCycle Engine applies built‑in, customizable rules and AI‑powered automation to correct coding and charge errors at the source, ensuring billing data is accurate before claims are submitted. By integrating seamlessly with EMRs and practice management systems, it ingests claims data in real time, applies industry‑proven rules tailored to each organization’s needs, and fixes errors automatically, reducing preventable denials and costly rework. Streamlined workflows prioritize and route only complex or exception claims for human review, boosting team efficiency and reducing burnout. With AI‑driven charge accuracy, the platform increases clean claim rates, lowers cost‑to‑collect, and stabilizes cash flow, all visible through clear dashboards and real‑time insights. Scalable automation handles high claim volumes without overtime or late‑night efforts, while features such as charge accuracy validation, denial prevention, coding review optimization, payment collection support, and more. -
17
Precision Practice Management
Precision Practice Management
Whether you're looking to outsource all of your revenue cycle management functions or just some of them, Precision Practice Management has the experience and expertise to help you stay on top of the constantly changing landscape in this most important area. Precision can successfully address all areas of revenue cycle management, from compliance, credentialing, coding, claims processing, clearinghouse edits and electronic lockbox to claim denial management, reporting, financial analyses and more. Your in-house staff may be doing a tremendous job in managing some or most aspects of your medical billing, but your office staff has many other important clinical functions to perform. Sometimes billing matters receive lower priority and suffer as a result. Precision's medical billing experts are focused entirely on medical billing and nothing else; that's all they do. -
18
Paradigm
Paradigm
Paradigm Senior Services offers a full-service, AI-powered revenue cycle management platform specifically tailored to home-care agencies that bill third-party payers such as the U.S. Department of Veterans Affairs (VA), Medicaid, and other managed-care payers. It automates and streamlines every step of the billing and claims process: from eligibility/authorization verification, state- or payer-specific enrollment and credentialing, to submission of clean claims, denial handling, and payment reconciliation. It integrates with common agency management software and electronic visit verification tools to scrub shifts, verify authorizations weekly, and reconcile payments, reducing denials and minimizing administrative burden. Paradigm also supports “back-office as a service” for providers; even if they already have internal billing staff or scheduling software, Paradigm can take over claims processing as a specialized, expert billing department. -
19
Adonis
Adonis
Adonis is an AI-powered platform designed to revolutionize revenue cycle management by providing monitoring, alerting, and dynamic issue resolution capabilities. It enhances task prioritization across RCM organizations through insights into denial trends, underpayments, and performance metrics. By leveraging AI-driven insights, Adonis aims to increase first-pass acceptance rates and minimize human errors, going beyond basic automation. The platform proactively prevents denials, automating routine tasks to allow teams to focus on patient care and experience. Adonis seamlessly integrates with existing electronic health records, practice management, billing systems, and patient portals in real time, eliminating data silos and ensuring a cohesive workflow. Its solutions are tailored for various healthcare organizations, including physician group practices, hospitals, healthcare systems, digital health providers, and practice management services. -
20
Assurance Reimbursement Management
Change Healthcare
An analytics-driven claims and remittance management solution for healthcare providers who want to automate workflows, improve resource utilization, prevent denials, and accelerate cash flow. Increase your first pass claim acceptance rate. Our comprehensive edits package helps you stay current with changing payer rules and regulations. Heighten your staff’s productivity with intuitive, exception-based workflows and automated tasks. Your staff can access our flexible, cloud-based technology from any computer. Manage your secondary claims volume through automatic generation of secondary claims and explanation of benefits (EOB) from the primary remittance advice. Focus on claims that need your attention with predictive artificial intelligence into problem claims. Resolve errors faster, and avoid denials before submittal. Process claims more efficiently. Print and deliver primary paper claims, or add collated claims and EOBs for secondary claims. -
21
ARIA RCM Services
CompuGroup Medical US
ARIA RCM Services is an end-to-end medical billing and revenue cycle management solution designed to enhance financial operations for practices, hospitals, and laboratories. The service offers flexibility by allowing clients to leverage their existing billing technology or utilize ARIA's systems, ensuring full transparency through a dedicated RCM team. Services are tailored to address specific needs, ranging from comprehensive revenue cycle management to focused areas such as aging accounts receivable and coding oversight. ARIA's team of regulatory and payment experts assists clients in navigating the latest CMS and payer requirements, aiming to minimize denials, reduce AR, and accelerate payment processes. The service emphasizes operational efficiency by combining industry best practices with proprietary workflow technology, delivering optimal results at a lower cost. -
22
eClaimStatus
eClaimStatus
eClaimStatus provides simple, practical, efficient and cost effective real time Medical Insurance Eligibility Verification system and Claim Status solutions that power value added healthcare environments. At a time when healthcare insurance companies are reducing reimbursement rates, medical practitioners must monitor their revenue closely and eliminate all possible leakages and payment risks. Inaccurate insurance eligibility verification causes more than 75% of claim rejections and denials by payers. Furthermore, refiling rejected claims cost an organization $50,000 to $250,000 in annual net revenue for every 1% of claims rejected (HFMA.org). To overcome the revenue leakages, you need a no-fuss, affordable and effective Health Insurance Verification and Claim Status software. eClaimStatus was designed to solve these specific challenges. -
23
Nextech
Nextech Systems
Revenue cycle management platform with payment processing, claims management, patient access, and denials management. Nextech’s specialty-focused technology solutions are personalized to meet the unique workflow requirements of specialty providers, helping practices increase efficiencies across their clinical, administrative, financial and marketing functions using a single platform. Offering all-in-one, ONC-certified electronic medical records (EMR/EHR), practice management, revenue management, and patient engagement software and services, Nextech is recognized as the top single solution provider for ophthalmology, plastic surgery and dermatology, serving a client base of more than 9,000 providers and 50,000 office staff members. Offering physicians intelligent healthcare technology, Nextech focuses on the success of its specialty practices through consultative guidance and implementation of solutions tailored to the speed and workflows of individual providers. -
24
RevvPro
RevvPro
Medical billing for healthcare providers is complex, and the old billing methods are now obsolete, with increased demands around documentation, compliance, and reduced reimbursements. Powered by ai, machine learning, and robotic process automation, RevvPro has addressed the severe shortage of certified medical billing staff and provides the missing transparency into real-time data such as claim status, denials using automation. All from a smartphone or desktop. The future of RCM, with RevvPro, answer your issues for proper reimbursement. Facilities are currently using different systems for practice management and EMR/EHR. They can continue to do so if they are comfortable using their current software systems. RevvPro sits like a blanket on top of their existing systems and extracts the needed information to provide transparency to the providers. RevvPro can be accessed by different functions with your revenue cycle team to seamlessly manage their respective workflows and processes.Starting Price: $199 per month -
25
WorkDone Health
Wrkdn, Inc.
WorkDone Health is an AI compliance copilot that prevents small medical documentation errors from becoming costly disasters. WorkDone Health integrates directly with hospital EHRs, monitors clinical activity in real time, and uses AI agents to detect and fix issues — like missed discharge notes or wrong medication times — before they trigger claim denials or audits. When a problem is found, our AI opens a quick conversation with the responsible staff member to confirm and correct it immediately. WorkDone Health doesn't just alert. We resolve — and help clinics and hospitals improve patient outcomes, get more revenue quicker, reduce claims denials, and reduce pressure on clinical teams. -
26
Availity
Availity
Collaborating for patient care requires constant connectivity and up-to-date information. Simplifying how you exchange that information with your payers is more important than ever. Availity makes it easy to work with payers, from the first check of a patient’s eligibility through final resolution of your reimbursement. You want fast, easy access to health plan information. With Availity Essentials, a free, health-plan-sponsored solution, providers can enjoy real-time information exchange with many of the payers they work with every day. Availity also offers providers a premium, all-payer solution called Availity Essentials Pro. Essentials Pro can help enhance revenue cycle performance, reduce claim denials, and capture patient payments. Availity remains your trusted source of payer information, so you can focus on patient care. Our electronic data interchange (EDI) clearinghouse and API products allow providers to integrate HIPAA transactions and other features into their PMS. -
27
Optimus Suite
EqualizeRCM Services
Innovative and industry-defining software solutions are at the heart of EqualizeRCM’s healthcare revenue cycle management strategy. Our RCM automation platform, Optimus Suite, seamlessly coexists with clients’ existing infrastructure (EMR, PM, Clearing House, Payer, and other systems). This platform, along with its set of intelligent applications, empowers facilities and practices to have efficient revenue cycle processes while reducing operational costs. Optimus can be tailored to integrate with your system and help bring your RCM performance to the next level. Denials and AR management system, enabling easy claim status, dashboard analytics, and root cause analysis of denials and AR. Platform to integrate 835 and 837 data into the denials and AR management process, enabling rapid claims analysis. A hosted, inexpensive, customizable contract payment calculator enabling calculation of expected payments per provider’s contracts and comparison to payments received. -
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Thoughtful AI
Thoughtful.ai
Thoughtful AI offers a comprehensive, AI-driven solution for healthcare revenue cycle management (RCM). With its human-capable AI agents, such as EVA for eligibility verification and CAM for claims management, the platform automates the most complex and time-consuming RCM processes. Designed to boost efficiency and accuracy, it reduces operating expenses, minimizes denials, and accelerates payment posting. Trusted by leading healthcare providers, Thoughtful AI provides seamless integration, guaranteed ROI, and the ability to reduce cost-to-collect, all backed by HIPAA-compliant security and performance-based guarantees. -
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Veradigm Payerpath
Veradigm
Veradigm Payerpath is an end-to-end revenue cycle management suite of solutions built to assist organizations to improve revenue, streamlining communications with payers and patients, and boosting practice profitability for practices of all sizes and specialties. Eliminate missing information, incorrect coding, and data entry error to ensure clean claim submission. Ensure claims pre-submission are correctly coded, have no missing information, and are error-free. Compare performance against peers at the state, national, and specialty levels to optimize productivity and improve financial performance with advanced analytical reporting. Remind patients of their appointments and confirm their insurance coverage and benefits information. Automate the billing and collection of patient responsibility. Veradigm Payerpath’s integrated solutions are practice management (PM) agnostic, interfacing seamlessly with all major PM systems. -
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Approved Admissions
Approved Admissions
Approved Admissions is a secure platform that automates tracking of coverage changes for Medicare, Medicaid, and commercial payers bundled with real-time eligibility verification and coverage discovery. The platform's primary goal is to help providers minimize the number of claim denials due to a missed insurance coverage change and accelerate the billing cycle. Approved Admissions is using the innovative RPA (Robotic Process Automation) Bridge solution to ensure patient data consistency across multiple systems, and benefit coverage search. Key Features: - Automated eligibility verifications and re-verifications - Email or API notifications if any coverage changes are detected - Real-time verifications - Batch eligibility verification - Seamless integration with RCM, EHR platforms (PointClickCare, MatrixCare, SigmaCare, DKS/Census, FacilitEase, and many others) - RPA-powered cross/platform synchronizationStarting Price: $100 per month -
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Acusis
Acusis
Acusis’ approach to Revenue Cycle Management (RCM) is full circle that provides finest experience to their clients. Acusis has a tenured team consisting of proven RCM experts and consultants on billing, coding, CDI, risk adjustment, HCC, account receivables and denials management. Clinical documentation management is simple and cost-effective with Acusis’ unique approach of combining cutting-edge technology and professional documentation services. While eCareNotes speech recognition platform helps Physicians save time and focus on delivering care, Acusis professional services team focuses on making life easy for HIM by offering superior editing services. From dictation capture to cutting-edge voice recognition, Acusis offers a wide array of cloud-based products for simplifying MTSO transcription workflow management. eCareNotes, the flagship technology platform helps MTSOs as well as in-house transcription teams of hospitals to reduce documentation costs and stay compliant. -
32
AxisCare
AxisCare Home Care Software
Designed for enterprise-level non-medical Personal Care and Medicaid agencies, AxisCare's award-winning, web-based scheduling and management software allows agencies to manage and grow with confidence. AxisCare's Scheduled Reports simplify reporting by automating generation with precise specifications, ensuring accurate data for critical business decisions. AxisCare's Veterans Affairs and Medicaid billing services streamline reimbursements. VA billing experts configure your system, prevent recoupments, and manage claim submissions with direct payments. Medicaid specialists deliver accelerated payments with clean EVV processing, reduce denials through claim scrubbing, and help explore additional revenue opportunities through waivers and MCOs. With robust scheduling, GPS Mobile App, EVV, hospitalization tracking, medication reminders, payment processing, and custom reporting, AxisCare is the easiest-to-use software in Home Care.Starting Price: $200 -
33
Inovalon Claims Management Pro
Inovalon
Keep revenue flowing with a powerful tool that speeds up reimbursements with eligibility checks, claims status tracking, audits and appeals, and remittance management for government and commercial claims, all in a single system. Leverage an advanced rules engine that immediately scrubs claims against the most up-to-date CMS and commercial payer rules, allowing you to correct errors before claims go out the door. Verify eligibility across all payers during claim upload and see flagged errors so claims can be edited before submission. Decrease days in A/R with automated workflows for audit responses, appeal submissions, and ADR tracking. Customize staff workflow assignments based on the type of claim and action needed. Automate secondary claims submissions to stop timely filing write-offs. Increase claims revenue with automated workflows for faster, more successful audits and appeals. -
34
CureAR
TechMatter
CureAR is an AI-powered medical billing and revenue cycle management software designed for in-house billers, billing companies managed-service providers and DME companies. The software consolidates eligibility verification, charge capture, AI-assisted coding suggestions, claim scrubbing, electronic claim submission, ERA ingestion, and automated payment posting into a single cloud-hosted system. It is configurable for specialty billing rules and supports multi-tenant operations for practices that handle multiple client accounts. Key Features: AI-assisted coding and claim scrubbing: Machine learning highlights likely coding errors and applies payer-specific validation rules before submission. Real-time claim status and alerts: Tracks claims from submission to adjudication and surfaces exceptions for prioritized follow-up. ERA ingestion and automated posting: Electronic remittance advice handling with configurable reconciliation workflows reduces manual posting effort.Starting Price: $129/month/user -
35
Remittance360
GAFFEY Healthcare
All organizations across the healthcare revenue cycle sector can utilize Remittance360. If an entity receives standard 835, business office staff of all levels will find this tool useful in making actionable decisions regarding cash and accounts receivable workflow. Remittance360 is simple and easy to use, start-up time is minimal, and the uploading process of 835 data takes seconds. Utilizing the standard 835 data set, information upload is obtainable for all organizations, with minimal IT involvement. Remittance360 takes advantage of the data organizations have, but delivers relevant reporting of denials, trends, and individual payer activities. Gaining insights into this information can determine specific workflow needs. The ability to query data is simple in Remittance360, and common queries can be saved for easy user functionality. Querying denials by remark code and by department can assist in identifying and fixing root cause issues. -
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TELCOR RCM
Telcor
Whether you are an independent reference lab, a pathology practice, an outreach lab or a public health lab, TELCOR RCM billing software provides the tools to overcome tough billing challenges and improve profitability. Perform claim submission, claim monitoring, remittance processes, AR management, client and patient billing, and much more for multiple NPIs all in a single revenue cycle management solution. Minimize billing staffing needs and maximize revenue cycle productivity by using the right tools to automate daily billing functions such as claims submission, collecting patient information, as well as generating revenue cycle management financial reports. Eliminate labor-intensive manual adjudication processes by processing electronic payments received from your payers via 835 ERAs or from your bank via lockbox payment files. Send quick and easy-to-understand billing communication to patients, simplify your patient billing process, and make it easier for patients to pay. -
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Casamba Revenue
Casamba
Fewer denials and delays in claim submission + a dedicated team to manage follow-ups. Grow revenue by 4% and net payment per visit by 10%. Improved collection efficiency and consistent follow-up help net collection percentages grow. Reduce your DSO by 10 days or more. Claims that meet exact requirements shorten collection timelines and increase cash flow. Dashboards and metrics allow you to make informed decisions and move your business forward. The integration of Casamba and IKS Health creates a unified solution tailored for physical therapy practices and the challenges you face. By combining technology and services, we bring exponential value. We make your practice more efficient by freeing you and your therapists to focus on the delivery of excellent care. Contact us to find out how our RCM service can help you grow your business. -
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AGS AI Platform
AGS Health
AGS AI Platform is an end-to-end Revenue cycle management platform that provides a full suite of revenue cycle solutions that can be configured to meet the unique needs of any healthcare organization. AGS AI Platform is designed to improve healthcare systems' revenue cycle performance by automating repetitive tasks, simplifying coding, improving documentation, and optimizing billing practices to prevent denials and improve revenue flow. It provides a connected solution that blends artificial intelligence and automation with award-winning human-in-the-loop services and expert support to maximize the performance of the healthcare revenue cycle. The platform allows healthcare organizations to gain enhanced visibility into day-to-day operations and the overall performance of the revenue cycle, including intelligent worklists, productivity reports, customizable dashboards, root cause analyses, and executive reporting. -
39
Sift Healthcare
Sift Healthcare
Sift demystifies healthcare payments by integrating actionable intelligence into revenue cycle workflows to help healthcare organizations optimize payment outcomes and reduce the cost to collect. Sift equips healthcare providers with actionable denials intelligence that enables them to protect their receivables and accelerate cash flow. Sift captures insurance claim and patient financial data into a HIPAA-compliant, cloud-based and normalized database, providing a single source of truth for around your healthcare payments. Sift fills the gaps between a provider’s EHR, clearinghouse, workflow tools, and patient engagement platform. Sift unifies the data points from each system to build a unique and proprietary data set and provide holistic payments oversight. By applying multiple data science techniques, Sift provides comprehensive and integrated recommendations for denials management, payer assessment, patient collections and patient acquisition. -
40
Rivet
Rivet Health
Patient cost estimates and upfront collection. Understand patient responsibility instantly with automatic eligibility and benefit verification checks. Hyper-accurate estimates based on your own practice data, creating better care and a healthier business. Send estimates via HIPAA-compliant text or email. It's time to treat 2020 like 2020. Collect more than ever with upfront mobile patient payments. Ditch the write offs and decrease patient AR. Run eligibility checks and provide accurate cost estimates, even for multiple payers, treatments, facilities or providers. Collect payment up front via HIPAA-compliant text or email. Reduce A/R days, collect more revenue and increase patient satisfaction all at once. Identify, analyze and resolve denials, as well as track ROI from reworked claims. Automate denial assignments to team members via Rivet, and leave notes and links along the way to resolve future denials even faster. -
41
MedClarity
Medusind
MedClarity is Medusind's turnkey RCM technology. MedClarity is a robust, web-based medical billing and practice-management software. The solution comes with a range of tools to enable medical practices of all sizes to take full control of their front-office and revenue operations. In addition to offering intuitive navigation and workflows, MedClarity boasts an advanced rules engine for clean claim submission, smart scheduler, comprehensive reporting and business analytics, real-time insurance eligibility verification, denial management and claim status lookup, and integration more than 30 EMR platforms. -
42
ImagineBilling
ImagineSoftware
The industry’s first intelligent, multi-specialty medical billing software. Streamlining billing and patient collections for over 75,000 physicians across the country. Globalized data eliminates the need for duplicate entry. Visit-driven to allow for large volume and complex information. Flexible data structure accommodates requirements across multiple practices and specialties. Helping you get paid faster. Post payment manually or through electronic remittance. Automatically scrub claims for errors and missing information. Automatically refile insurance claims based on selected criteria. Fast review to evaluate and approve charges. Audit charges by modality, procedure, insurance, user, doctor or date of service. Intuitive reports for tracking the financial health of your front-end and back-end billing. Never lose another charge again. Integrates with your preferred clearinghouse or statement vendor. -
43
ABN Assistant
Vālenz
For providers, medical necessity denials cost thousands to millions of dollars every year in write-offs, plus costly staff time researching and appealing denials and responding to patient concerns. For payers, the same is true on the other end of the claim management spectrum: Paying for medically unnecessary procedures and treatments – and time spent working on denial appeals – raises costs without improving outcomes. And of course, for the patient, there can be unnecessary copays and other out-of-pocket costs, not to mention a poor patient experience involving costs and moments of care they did not need. ABN Assistant™ from Vālenz® Assurance delivers the prior authorization tools providers need to validate medical necessity, print Medicare-compliant ABNs with estimated cost, and stop over 90 percent of medical necessity denials by verifying necessity before care is delivered to the patient.Starting Price: $1039.00/one-time/user -
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ZOLL AR Boost
ZOLL Data Systems
With patients increasingly responsible for more out-of-pocket expenses than ever before, correctly identifying self-pay patients and capturing maximum reimbursement for all services rendered can be a challenging and labor-intensive exercise. ZOLL® AR Boost® is a real-time accounts receivable (AR) solution that simplifies and expedites the pre-billing process, ensuring that no payments are left on the table. By delivering accurate, actionable data to reveal hidden coverage and drive self-pay and high-deductible conversions, ZOLL AR Boost helps healthcare billing professionals to capture complete patient information on the front-end and deliver 12% more revenue on average, faster and with 60% less returned mail. Missing or inaccurate patient information causes claim denials, delays reimbursement, and leaves patients feeling frustrated. Manually filling the data gaps wastes time and leads to misidentifying too many insured patients as self-pay. -
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Quadax
Quadax
How well you manage the challenges of your revenue cycle has a direct effect on your bottom line and the success of your entire organization. It doesn’t matter how many patients seek your care if it’s taking months to receive the expected payments for the services you provide. And, you shouldn’t have to spend hours each day tracking down the payments you’ve worked hard to earn. There’s a better way to maximize healthcare reimbursement. Let Quadax be your guide to creating a comprehensive, sustainable and orderly strategic plan, and select the right technology solutions and services that best fit your business model. With us as your partner, you can achieve operational efficiency, optimize financial performance and enhance the patient experience. The goal for every claim going out the door is to avoid a denial and get paid as quickly as possible. -
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Amazing Charts Practice Management
Amazing Charts
Amazing Charts Practice Management is a comprehensive solution designed to streamline administrative tasks and enhance the efficiency of independent medical practices. Developed by a practicing physician, this system automates processes such as capturing patient demographics, scheduling appointments, pre-registering patients with insurance eligibility checks, and generating analytical reports. It also determines patient financial responsibilities at the point of care, maintains insurance payer lists, and ensures prompt and accurate billing to assist in payment collection efforts. Key features include the ability to view unpaid claims to ensure timely resolution, a claims manager who reviews submissions to reduce denials, and an integrated secure connect clearinghouse for high-level support and quick responses to payer changes. The system offers intelligent, interactive role-based dashboards that automatically prioritize work lists across all office areas.Starting Price: $229 per month -
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HCC Coding Engine
Aptarro
Aptarro’s HCC Coding Engine is an AI‑powered solution that integrates seamlessly with electronic medical records and practice management systems to scan every patient encounter in real time, automatically identifying and closing coding gaps to ensure all Hierarchical Condition Category (HCC) diagnoses are accurately captured for optimal risk adjustment and revenue. By applying industry‑proven rules and machine learning models, it prioritizes high‑value encounters for coder review, boosts productivity up to 300% per coder without adding provider workload, and reduces denials through real‑time validation and compliance updates. With exception‑based workflows, clear dashboards for RAF score trends, built‑in audit trails and logging, and fast implementation within existing workflows, organizations see immediate ROI in their first billing cycle and unlock millions in missed revenue while maintaining clinical focus and documentation integrity. -
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Stedi
Stedi
Stedi is the only clearinghouse built on modern APIs, while supporting both real-time and batch EDI processes. It enables health techs and incumbents to exchange mission-critical transactions - from eligibility to claims and remits. With a security-first cloud infrastructure, built-in payer redundancy via 3,400+ route connections, and market-leading sub-10-minute support response times, Stedi provides reliability and responsiveness to avoid billing outages and reduce denials.Starting Price: $2,000 per month -
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Dastify Solutions
Dastify Solutions
Dastify Solutions is a U.S.-based, AI-powered medical billing company trusted by 1,000+ healthcare providers nationwide. They specialize in high-accuracy RCM, leveraging advanced AI and a team of 500+ AAPC/AHIMA-certified coders to reduce errors by up to 99%. They offer end-to-end services, including coding, AR recovery, credentialing, and denial management, customised for 75+ specialities on a flexible pay-for-paid model. Their platform integrates seamlessly with 600+ EHR / EMR systems.Starting Price: $50 -
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Crosby Health Apollo
Crosby Health
Thousands of providers use Apollo by Crosby Health to generate, submit, and track appeals. Reducing the provider burden from clinical denials. Apollo has been trained to understand the clinical context and beats every other medical language model on core metrics. Apollo has been fine-tuned to handle billing tasks with high precision such as auditing, charge capture, and denial management. The fastest clinical language model with the largest context length. Outputs are generated on average at 60 words per second and can intake up to 300 pages. Our AI crafts winning appeal letters for every denial with meticulous arguments for maximum recovery. Eliminate multiple payor portals and fax numbers. One platform that submits and tracks every appeal. Eliminate the provider burden to generate appeals. AI trained to identify medical necessity within documentation. One-click submission to any insurance company.
